Did You Know?
HIV-related stigma continues to be pervasive among clinicians who serve communities of color (1)?
Issue: Stigma remains a major barrier to HIV/AIDS testing and treatment. Research shows that clinicians who exhibit stigmatizing behaviors can exacerbate feelings of isolation, and prevent individuals from getting tested and from accessing care. This often leads to delays in early detection, counseling and treatment. Once diagnosed, stigma may also prevent patients from continuing treatment and care. The purpose of this study was to explore HIV-related stigma among clinicians who serve communities of color, and to examine stigma's influence on provider behavior.
Description: We used a mixed approach (qualitative and quantitative) to examine HIV-related stigma among clinicians of color. Participants were selected using convenience sampling. Our study addressed two distinct constructs of HIV-related provider stigma: 1) a clinician’s willingness to provide HIV treatment and 2) a clinician’s willingness to offer an HIV test to a patient.
Lessons learned: Data obtained from a sample of self-identified HIV specialists working primarily in clinical and university-based settings showed that stigma impacts both the i) quality of treatment and ii) the likelihood that a test is offered to patients seeking care. In particular, substance abuse history 54%, sexual practice behaviors 45% and need for mental health services 41% were most frequently identified as influencing the likelihood that an HIV test is offered to a patient and whether a provider is willing to offer treatment for HIV/AIDS. Additionally, a significant finding was the high frequency of stigma associated with clinicians providing HIV care for over ten years. For these clinicians who provided care for more ten years , findings revealed that the ability to communicate in the same language as the patient 49%, comfort of HIV pharmacology 47%, and level of training to clinically manage HIV/AIDS 47% also influenced care and treatment decisions.
Next steps: Interventions that target provider attitudes and potential biases regarding HIV/AIDS are fundamental to successfully reducing stigma. Also, providing clinicians with continuing education credits for attending trainings that promote effective communication, including cultural competency with patients involved in HIV treatment, seem warranted.
(1) National Minority AIDS Education and Training Center (NMAETC), Howard University College of Medicine, Department of Infectious Diseases. December, 2009. Goulda A. Downer, PhD, Principal Investigator; Keisha Watson, PhD, Data Manager; Sheila McKinney, MA, Program Manager-Measurement and Evaluation.